Volume : 2, Issue : 10, OCT 2016

HELICOBACTER PYLORI ERADICATION IMPROVES SPLENECTOMY RESULTS IN REFRACTORY IDIOPATHIC THROMBOCYTOPENIC PURPURA

Khalighi AR, Rahimi H, Esmaeelzadeh S, Behdani R, Jamali J, Shirdel A, Khosravi A, Kouhestani Sh

Abstract

Background Management of chronic idiopathic thrombocytopenic purpura (ITP) refractory to medical treatments has been a major challenge. While splenectomy is the most effective treatment for ITP, its success cannot be ensured. Despite the confirmed relationship between Helicobacter pylori infection and chronic ITP, the efficacy of H. pylori eradication in enhancing the response to splenectomy has not been well examined. The present pilot study examined the effects of H. pylori eradication on improving response to splenectomy in patients with ITP. Methods In 50 cases who were found to have both chronic ITP unresponsive to medical treatment and H. pylori infection, eradication treatment was given. From March 2007 - 2015 these patients had been followed up precisely by their platelets count. Among them 38 patients who needed splenectomy followed up in a five-year period, and the complete response rate compared with the global one. Results Of all the ITP patients who underwent both H. pylori eradication and splenectomy, 36 (94.7%) subjects exhibited a complete response. Two patients (5.3%) also showed a partial response and the overall response rate (ORR) was hence 100%. There was a significant difference between complete response rate to splenectomy in the present research and the previously reported rates throughout the world (P < 0.0001). Conclusion This research suggested the efficacy of H. pylori eradication in enhancing sustained response to splenectomy in patients with refractory ITP. Considering its accessibility and affordability, H. pylori eradication is strongly recommended as an adjuvant therapy in refractory ITP before splenectomy.

Keywords

Helicobacter Pylori, Idiopathic Thrombocytopenic Purpura (ITP), Splenectomy.

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